Antifungal Dosing Strategies for Critically Ill Patients

This article provides updates on antifungals, dosing strategies for safe and effective therapy in the critically ill, including special populations, and the understanding of resistance over the last 5  years.Recent findingsReports of adverse effects with echinocandins have risen while antifungal resistance to this class has increased, especially inCandida glabrata. New formulations of posaconazole and isuvaconazole have been developed. Alternative dosing strategies including combination therapy are being evaluated for difficult to treat fungal infections. Other highlights include additional data on dosing patients with severe organ dysfunction, including those on continuous renal replacement therapy, and new breakpoints for individualCandida species being established for the echinocandins and triazole classes.SummaryIncreasing resistance inCandida spp. has made susceptibility testing a standard of care for critically ill patients. New formulations of the triazole antifungals have made prevention and treatment of mold infections more of a reality. There are many implications that must be considered when treating critically ill patients due to alterations in pharmacokinetics and pharmacodynamics in order to ensure adequate treatment. This article exposes the need for further clinical research in treating invasive infections in this patient population.

Source: Current Fungal Infection Reports - February 8, 2017 Category: Infectious Diseases Source Type: research